比较ABCD^2-I与ABCD^2评分预测短暂性脑缺血性发作患者卒中复发的价值

COMPARISON OF PREDICTIVE ACCURACY OF ABCD^2 AND ABCD^2-I IN TRANSIENT ISCHEMIC ATTACK

目的比较ABCD2评分与ABCD2-I评分在短暂性脑缺血发作(Transient Ischemic Attack,TIA)患者中预测卒中复发的效度。方法前瞻性、连续纳入发病7d内且完成核磁弥散加权成像(Diffusion Weighted Imaging,DWI)的TIA患者,对其进行1年随访,评价指标是卒中复发。将ABCD2评分与ABCD2-I评分分为低危、中危、高危三组,评价二种评分对TIA患者进行卒中复发风险分层的能力;采用曲线下面积(Area Under the Curve,AUC)比较二种评分预测卒中复发的效度。结果纳入符合入排标准的患者共410例,其中110例患者(27.07%)1年卒中复发。ABCD2评分低、中、高危卒中复发风险分别为21.88%,27.64%,41.18%,ABCD2-I评分低、中、高危卒中复发风险分别为4.71%,21.94%,49.61%。ABCD2评分的预测效度AUC=0.59,ABCD2-I评分的预测效度AUC=0.77。结论 ABCD2-I评分较ABCD2评分能更好地预测TIA患者1年卒中复发。

Objective To compare the predictive accuracy of the ABCI）2 score and ABCD2 - I score in pa- tients with transient ischemic attack （TIA）. Methods Patients within 7 - days TIA and completed diffu- sion weighted imaging （DWI） were recruited from Beijing Tiantan Hospital, Capital Medical University prospectively and consecutively. All patients should complete 1 - year followed up and the outcome was stroke. We evaluated the predictive values of ABCDz and ABCD2 - I to stratify 1 - year of recurrent stroke in low- risk, medium- risk and high- risk group and compared the predictive accuracy of ABCIY and AB- CD2 - I for recurrent stroke with area under the curve （AUC）. Results Four hundred and ten patients who completed DWI and 1 - year follow- up with initial TIA were enrolled in this study. Among all the pa- tients, 111 （27. 07%） patients had annual stroke risk. The risk of stroke was respectively 21. 88%, 27.64%, 41.18% in low- risk, medium- risk and high- risk in ABCD2 score and 4.71%, 21.94%, 49.61% in low- risk, medium- risk and high - risk in ABCDz - I score respectively. The risk of stroke increased with increasing ABCD2 score and ABCD2 - I score. The ABCD2 - I score had the higher predic- tive value with areas under the curve of 0.77 than the ABCD2 score with areas under the curve of 0.59. Conclusions The predictive accuracy of ABCD2 - I score for 1 - year stroke is higher than ABCD2 score in patients with TIA.